Disclosures The authors wish to thank Amylin Pharmaceuticals for funding the development of this article through an unrestricted educational grant. The authors independently produced this manuscript and are solely responsible for all content. JU has served on as an advisory board member for Amylin Pharmaceuticals, Inc., Novo Nordisk Pharmaceuticals. He has received honoraria as a member of the speakers bureau for Eli Lilly and Company, Novo Nordisk, and Amylin Pharmaceuticals and has received research grants from Amylin Pharmaceuticals, Inc., Takeda Pharmaceuticals, Novo Nordisk Pharmaceuticals, Roche Pharmaceuticals, GSK Pharmaceuticals, and Sanofi-Aventis Pharmaceuticals. DH has served as an advisory board member for Eli Lilly and Company and Abbott Diabetes Care. She has also served as a consultant for Roche Diagnostics, Amylin Pharmaceuticals, Inc., and Sanofi-Aventis. BS owns stock in Amylin Pharmaceuticals, Inc. CP has received consulting fees and funding for educational programs from Abbott Diabetes Care, Amylin Pharmaceuticals, Inc., Bayer Diagnostics, Eli Lilly and Company, Generex Pharmaceuticals, LifeScan, Medtronic MiniMed, Roche Diagnostics, Sanofi-Aventis, and Smiths-Medical.
Putting medications where they belong: Practical advice for managing type 2 diabetes in clinical practice
Article first published online: 4 MAY 2012
©2012 The Author(s) Journal compilation ©2012 American Academy of Nurse Practitioners
Journal of the American Academy of Nurse Practitioners
Volume 25, Issue 2, pages 65–76, February 2013
How to Cite
Unger, J., Hinnen, D., Schreiner, B. and Parkin, C. (2013), Putting medications where they belong: Practical advice for managing type 2 diabetes in clinical practice. Journal of the American Academy of Nurse Practitioners, 25: 65–76. doi: 10.1111/j.1745-7599.2012.00736.x
- Issue published online: 24 JAN 2013
- Article first published online: 4 MAY 2012
- Manuscript Accepted: JAN 2011
- Manuscript Received: AUG 2010
- Diabetes type 2;
- faculty practice;
Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder that affects almost 24 million Americans. Healthcare providers often do not initiate and/or intensify therapy appropriately during patient visits, which may be due, in part, to a lack of understanding of the new diabetes medications. This review focuses on means by which primary care nurse practitioners (NPs) might evaluate the utility of pharmacologic agents based upon their relation to the pathogenesis of T2DM.
The evidence used in developing this review included evidence-based reviews, clinical trials, cohort studies, position statements, and guidelines. The authors obtained relevant reports through a computerized search of the literature using PubMed, MEDLINE, and other search engines and scanning syllabi from national and international meetings on the subject of type 2 diabetes.
Medications used to manage T2DM utilize different pharmacologic approaches. These include stimulating insulin production, reducing hepatic gluconeogenesis, slowing polysaccharide digestion, and increasing insulin sensitivity in muscle, liver, and fat to achieve euglycemia.
Implications for practice
Patients with T2DM should be treated to their lowest targeted glycemic goals as soon as they are diagnosed as safely and as rationally as possible. NPs in primary care practice can facilitate more effective diabetes management.